Academic journal article Pre- and Peri-natal Psychology Journal

Fantasy State during Pregnancy: A Psychoanalytic Account

Academic journal article Pre- and Peri-natal Psychology Journal

Fantasy State during Pregnancy: A Psychoanalytic Account

Article excerpt

ABSTRACT: Fantasy during pregnancy is a very common occurrence, especially during the third trimester. It is often disturbing to the woman, and may provide insights into client concerns of clinical relevance to the health care professional who delivers care to this population. This paper reports on a preliminary classification schema for third trimester fantasies, based on a survey of fantasies reported by pregnant women during this time period. Clinical examples of counseling situations using the schema to identify pregnant clients' problems and concerns are discussed. Assessment of fantasy state during pregnancy is seen as one important component to be included in delivery of care to the whole woman.

As a concept of interest in health care and health care delivery, fantasy has been largely ignored. However, it continues to play a prominent role in the various schools of psychoanalysis from which come many theoretical speculations concerning prenatal life.

Recently, health care professionals, in particular, nurses, have begun to be interested in fantasy as an indicator of health (Blair, 1987, Sherwen, 1987, Sherwen, 1986, Lederman, 1984, Sherwen, 1981) and to evolve qualitative and quantitative measurement tools to observe fantasy state in humans. In particular, pregnancy appears to be a state in humans when fantasy performs important functions for the woman, and her evolving relationship with the fetus and infant-to-be (Winestine, 1989, Notman, Lester, 1988, Rubin, 1984, Lederman, 1984). This paper concerns the state of fantasy production during pregnancy.

Many classic theorists indicate that fantasy pattern is actually altered during pregnancy. Deutch (1965) believed that feminine anatomy directly affected a woman's fantasy, which, during pregnancy, was said to help her become more and more passive in awaiting motherhood. Benedek (1970) saw fantasy influencing the emotional course of pregnancy and therefore the mother's attitude toward the child. The future mother-child relationship might depend on the woman identifying with and fantasizing about the fetus as the "loving and loved self," a state fortunate for both mother and fetus. Alternatively, she might see the fetus as the "bad, aggressive, devouring self and fantasize about carrying a monster, resulting in panic or depression. Such fantasies augur poorly for the evolving mother-child relationship.

Similar to Benedek, Caplan (1959) based formulations concerning fantasy during pregnancy on his clinical observations. He also believed that future relations of the mother to her child are a direct continuation of the mother's relation to her fetus and are mirrored in fantasy content. Caplan believed that the first important aspect of infant-to-be representation in fantasy was the age of the fantasized infant. He held that the best maternal-child relationship would result if the mother fantasized the baby as a little baby, and that day dreams of a young infant were positively emotionally toned. Caplan had found that women who only dream of older children often fear the very young infant as an uncontrollable bundle of instincts.

Another important aspect in pregnant fantasies, to Caplan, was the fantasized sex of the infant. If the mother fantasized infants of both sexes and was indifferent to the sex of her fetus, a positive motherchild relationship was postulated. If the mother consistently fantasized about one sex in the infant, a possible conflict in the maternal-child relationship might be anticipated.

More descriptive information of fantasies in pregnancy came from the clinical observations of Rubin (1972, 1984), who found a discernible fantasy pattern as the pregnancy progressed. Early in pregnancy there were fewer fantasies than there were later on in the pregnancy. In the first trimester, fantasies about the child seemed to stem from outside stimuli, often symbolically linked to pregnancy, such as an egg. During the second and third trimesters, fantasies were more specifically related to what the child would be like when it arrived, and were rich and vivid in content. …

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